Syrian refugees denied health care due cash crunch -UNHCR

April 26, 2013|Reuters

* Doctors choosing which refugees get treatment

* Some patients with costly chronic diseases denied care

* UNHCR's $1 billion appeal only 55 pct funded

By Stephanie Nebehay

GENEVA, April 26 (Reuters) - Doctors at Syrian refugee campsin Lebanon and Jordan are having to decide between treatingacute cancer patients and helping deliver babies due to severeshortages of cash, the United Nations said on Friday.

More than 1.4 million Syrian refugees have now fled theirshattered homeland for neighbouring countries whose health caresystems are straining to meet the needs of their populations, insome cases suddenly swollen by 20 percent, it said.

But an appeal by U.N. High Commissioner for Refugees for $1billion through mid-year is only 55 percent covered. This hasmeant that some of the costly medical care for chronic diseasesis being denied, although emergency cases are treated, it said.

"We will prioritise paying for a woman's delivery instead ofpaying for treatment of a cancer patient with a poor prognosis.That is bad, but we have to do it. These are hard decisions,"Dr. Paul Spiegel, UNHCR's chief medical expert, told Reuters.

Acute respiratory infections and diarrhoea are the mostcommon ailments among Syrian refugees, three-quarters of whomare women and children, the UNHCR said in its first report basedon medical consultations in Iraq, Jordan and Lebanon. No datawas available from Turkey, it said.

Some refugees require treatment for hepatitis A infections,others for skin lesions due to leishmaniasis, it said.

Both diseases have broken out in Syria, whose health systemand drug industry have collapsed due to the conflict betweenSyrian government forces and rebels, now in its third year.

"NOT THE HEALTHIEST POPULATION"

But many of the refugees are elderly, suffering from chronicdiseases such as diabetes, lung disease, cancers orcardiovascular disease, who received free treatment under theircountry's socialised medical system, it said.

Spiegel, referring to treatment for diabetes, told a newsbriefing: "With renal dialysis you don't pay for a month andthen stop, you pay forever.

"And then very hard decisions are made, and many are notfunded, and therefore they either have to find other funding andin some cases, yes these patients may die."

Syrians are used to high-quality medical service, morecomparable to that in Europe than in Africa, Spiegel said.

"This is not the healthiest population, there is smoking, afair bit of obesity and not much exercise," he added.

In Iraq and Jordan, refugees have access to free health careat all levels.

But an "elective care committee" meets each month in Jordanto discuss refugee patients whose treatment exceeds a fixedfinancial ceiling, UNHCR said. In the first three months of theyear, 158 Syrians were reviewed, with treatment approved forcardio cases, perinatal cases and acute renal failure, it said.

In Lebanon, which has a largely privatised health caresystem and cost sharing is the norm, refugees must pay forreferrals to experts for specialised care. An elective carecommittee held its first meeting in late March to review cases.

Iraq is studying whether to set up such reviews, it said.

"People are spending more out of their pocket. Refugees arecoming from a system where they are not used to paying. Thelonger they stay, the less they have," Spiegel said.

Antonio Guterres, U.N. refugee chief, warned in mid-Marchthat the number of refugees outside Syria could triple by theend of the year from 1 million at that time.

"The challenges of providing access to affordable andquality health care for Syrian refugees will only increase inthe months to come," the UNHCR said in its report on Friday.